Clinical efficacy of de-epithelialized flap for reconstruction of pressure ulcers in the buttocks and trochanteric regions

OBJECTIVE: To evaluate the clinical efficacy of the De-Epithelialized Flap technique in the reconstruction of pressure ulcers in the buttocks and trochanteric regions. METHODS: A total of 29 patients with pressure ulcers in the buttocks and trochanteric regions were treated from January 2018 to November 2021, including 16 cases in the sacrococcygeal region, 4 in the intertrochanteric region, and 9 in the ischial tuberosity. Early debridement and drainage were performed to remove necrotic tissue and sinus tracts, followed by repair of the pressure ulcers using the De-Epithelialized Flap. The flap's length in the advancement direction should measure approximately 1.5-2 times the diameter of the defect, with the width slightly exceeding that of the wound. Excess tissue at the recipient site is de-epithelialized and used to fill the dead space. RESULTS: Among the patients, 27 cases achieved primary healing of the skin flaps, while 2 cases experienced delayed wound healing. These wounds were successfully managed with dressing changes and debridement. During a follow-up period of 6-12 months, only 1 case of recurrence at the same site was observed. CONCLUSION: The use of the De-Epithelialized Flap for the repair of pressure ulcers in the buttocks and trochanteric regions offers the benefits of being a simple, safe, and effective procedure with a low recurrence rate. This technique demonstrates promising clinical value and is recommended for broader clinical application.